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Letter to the editor regarding “Operating without direct supervision during pediatric surgery fellowship: When, how, and why”

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Topic overview

This letter responds to research on operative autonomy in pediatric surgery fellowships, highlighting the lack of formal criteria for unsupervised operations across training programs. The authors emphasize critical gaps in governance and ethical standards, particularly regarding parental consent for teaching assistant cases in competency-based surgical education.

Key takeaways

  • Only 7 of 44 pediatric surgery programs have formal criteria for unsupervised trainee operations, revealing significant governance gaps.
  • No programs require explicit parental consent when trainees operate as 'teaching assistants,' raising ethical transparency concerns.
  • Competency-based surgical education lacks standardized frameworks for granting operative autonomy to fellows.
  • Formal criteria and informed consent protocols are needed to balance trainee autonomy with patient safety and ethical standards.

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How to cite: GlobalCastMD. Letter to the editor regarding “Operating without direct supervision during pediatric surgery fellowship: When, how, and why”. GlobalCastMD Medical Library. 2025-10-23. https://library.globalcastmd.com/article/11149

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